Provider Demographics
NPI:1285867002
Name:SUSSLER, RAQUEL (MSW)
Entity Type:Individual
Prefix:MS
First Name:RAQUEL
Middle Name:
Last Name:SUSSLER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 18THST. NW
Mailing Address - Street 2:#603
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20036-6507
Mailing Address - Country:US
Mailing Address - Phone:202-496-0695
Mailing Address - Fax:
Practice Address - Street 1:1325 18TH ST NW
Practice Address - Street 2:#603
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-6515
Practice Address - Country:US
Practice Address - Phone:202-496-0695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-27
Last Update Date:2009-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3020161041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical